Published byStanford Medicine

When the International AIDS Conference was held in Washington, D.C. this summer, it cast a spotlight on the U.S. epidemic, which continues apace. Every year, there are some 50,000 Americans newly diagnosed with HIV – a figure Anthony Fauci, MD, the nation’s top AIDS doctor, has called “embarrassing.”

To help contain the epidemic, which affects an estimated 1.2 million Americans, the U.S. Preventive Services Task Force today issued a new draft recommendation that urges everyone in the country – adolescents and adults between 15 and 65 – to get an HIV test. The task force has recommended screening in the past but only among those considered at increased risk. And the federal Centers for Disease Control also has advised routine voluntary screening, but has allowed people to opt out.

We think it’s important for everyone to screen once because treatment helps people live longer, healthier lives and also prevents transmission to others

Doctors and patients may be reluctant to test because they don’t see a reason to do so or are afraid to broach a topic that still carries a lot of stigma. But there are as many as 250,000 people in this country who are HIV-positive and don’t even know it. They could benefit from treatment – and so could the rest of the population, if this epidemic is to be brought under control.

“We think it’s important for everyone to screen once because treatment helps people live longer, healthier lives and also prevents transmission to others,” task force member Douglas K. Owens, MD, a professor of medicine at Stanford, told me.

In recent years, the science of AIDS has advanced to the point where it’s clear that early testing and treatment can make a big difference. People who are diagnosed early – even before symptoms show up – and then receive antiretroviral treatment can reduce their odds of getting serious AIDS-related complications. And a landmark study also has shown that treatment drives down the amount of circulating virus in a person’s blood to the point where the infected person is significantly less likely to pass the virus on to others.

Also, once people know their HIV status, they are more likely to take steps to reduce the risks of transmission, such as using condoms, studies have shown. All these factors, taken together, point to the need for a universal testing program, Owens says.